Capitol Hill Blue Forums Political Issues Politics In General GOP at war with itself on health care

wow I am in utter (not udder) amazement


he actually said he very very very strenuously disagrees, which in Trumpland makes it true

Obviously, every Republican is lying about their health insurance plan, one way or another. But it has real consequences: Real medical bankruptcies, real people denied coverage, real people dying. The facts will all come out, if they can pass it. We'll be able to add up the cost in dollars and lives, for years after the fact.

Are they really planning on staying in politics after hurting so many people? Or is this some kind of final con-job before they all flee ahead of the tar and feathers?

You can always tell when one of their lies is imminent, as it is prefaced by: "And the fact of the matter is ________ fill in the bullscheis da jour. Should at least go with: and the alternate-fact of the matter is...

Tat

Republican Death Panels

One thing I find hilarious: They don't even seem to realize how health care works. I have an insurance plan (Blue Cross), a Medical Group (Scripps Physicians) and a Primary Care Physician. I also have some specialists within that Medical Group I can go to directly, but for anything new I go to my PCP first.

Republicans are always talking about a health care "market" that doesn't exist, as if I can shop for prices and then go to any doctor anywhere with the best price. They act as if I could shop for the best drug prices: I am in a Medicare Plan C so my drug prices are all going to be exactly the same everywhere, because they made it that way.

Good points, which bring the focus to the common confusing conflation of "health insurance" and "health care". Leaving aside health care for the moment (since the ACA, no matter which version, is only about insurance plans), insurance of any kind is a fundamentally socialist model ("socialist" meaning that people act as a group for mutual benefit). Insurance is people grouping together (pooling) to distribute risk. On average, everyone pays more for their eventual health care under this model than they would if they just paid for it as needed - the basic reason being the cost of managing the pool, and secondarily the cost of profit, if the insurance is a private venture.

The heartburn over the ACA is that it is an attempt to make a Frankenstein's monster out of the need to regulate "free market capitalism" (which, on it's own, excludes large numbers of people from the "market", thus negating the essence of the concept of "insurance"), and the social need to get everyone a decent level of health care.

Other "free market" shortcomings are due to the fact that the market for insurance is not nimble - buying into a "plan" is a fairly long-term commitment and many restrictions are embedded into the contract that inhibit plan swapping.

It is possible to have more "free market" health care, that is not connected to health insurance. I know of some examples of physicians who quit taking insurance and who are supposedly making just as much money off of co-pay level revenues. I haven't heard much about it recently - don't know if that means it doesn't work or if it just doesn't make the news. But such a model still does not address the major health crises.

Unfortunately, while the debate is mired in the mess of how to force a social need into a free market model, we are prevented from rationally considering how to pragmatically provide our society with adequate health care. The conservative ideology of capitalism and the free market ruling above all else has put them (and us) in an impossible situation.

The Republican/conservative problem is predicated on the fact they never wanted anything to do with any plan involving health care (insurance). But ACA made it impossible for them to ignore. Thus they had to devise an ideological plan in an attempt to address health care (insurance).

Ideologically they had to remove government from the equation and thus they have to formulate something based on the "free market". The problem is the "free market" never found a solution for people who are too poor to afford the high cost of insurance or emergency health care. Now Republicans/conservatives believe? they can provide a solution.

The CBO score characterizes the Ryan/Trump plan for what it is i.e. no government involvement. Thus people will loose insurance through either lack of affordable plans or forced ending of medicaid. Of course the plan will save $337B/10 yrs since they have removed government payments/taxes. Of course the cost of insurance will go down because only healthy people will remain in pool.

The Republican/conservative rebuttal is better coverage. So what they want to sell are plans in which there are low deductibles at very affordable prices. They believe a carrier in SC will offer a plan to someone in Utah at lower costs than local health care costs. No company would do that but they would where they could make money. Thus the local market determines plan prices regardless of where one buys it.

Free market competition does not drives prices lower than health care costs. If health care cost drivers continue to rise, plan prices will rise commensurately. I have not seen anything in the Republican/conservative plan which addresses health care cost drivers, other than to say free market competition will force the costs lower.

Every plan must have three things to achieve the basic goal of affordable "universal" health care.
1. the itemized list of no pre-existing, no caps, etc
2. a large pool of healthy people who are required to maintain a plan
3. programs to cut health care cost drivers

Notice this does not have to be a government operated program, but it does have to be government instituted.

I am thinking of an organizational change to implement universal health care. Create a single group with an algorithm to apportion buy in and share profits, with flexibility for changing composition. A single group would reduce organizational overhead. Offer single priced comprehensive plans with national coverage. Create a board for intelligent medical procedures. Create a plan for increasing medical personnel to adequately cover rural and urban centers. Everyone must buy a plan.

Just rambling spitballing

Distilled to it's most basic truth, the conservatives are wanting to con us into believing that they can do an impossible thing with enough waving of the free market, anti-government wand.

The solution is for Republicans to do nothing. Let Obamacare die a painful and public death, then do nothing again. The federal government should never have become involved in healthcare, it should be a states issue.

Tim

But they did and there's no putting the genie back in the bottle.


Perhaps. California is considering a state sponsored single payer health insurance system. If it works, other states might follow suit.

Which is what they do best.